Time to Sputum Culture Conversion in Multidrug-Resistant Tuberculosis: Predictors and Relationship to Treatment Outcome

Abstract

Under program conditions in Latvia, most patients with multidrug-resistant TB achieved sputum culture conversion within 12 weeks of starting treatment. Chest radiography and sputum culture drug susceptibility testing can assist physicians in predicting which patients will convert more slowly. Sputum culture conversion is a useful and appropriate interim indicator of treatment outcome in patients with multidrug-resistant TB.

Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at DOTS-plus projects

“…Malnutrition, positive baseline smear, and delayed culture conversion were previously demonstrated as risk factors for poor outcomes of MDR-TB treatment. 2,11 Our findings suggest that fluoroquinolones play an important part in TB treatment, which concurs with previous studies demonstrating that fluoroquinolone resistance was associated with poor MDR-TB treatment outcomes. 2,12,13 Regimens for treatment of TB that include fluoroquinolones need to be strong enough not to amplify resistance to fluoroquinolones.…”

The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis

“…302 Other factors-such as HIV co-infection, previous history of tuberculosis treatment, resistance profile (MDR vs XDR vs other), extent of total and cavitary disease on chest radiograph, presence of comorbid conditions such as diabetes mellitus, and initial microbiological burden-might all have some role in predicting treatment response. [304][305][306] Therefore, the need to develop a composite tool that can predict long-term outcomes of failure and relapse is urgent. Such a tool, once validated, would have the potential to significantly shorten the approval of new interventions for MDR tuberculosis.…”

Treatment Outcomes for Patients with Multidrug-Resistant Tuberculosis in Post-Earthquake Port-au-Prince, Haiti

“…[29][30][31] Interestingly, patients with isolates resistant to pyrazinamide were found to be less likely to achieve culture conversion by 60 days. The introduction of the Xpert MTB/ RIF assay allowed for rapid diagnosis of MDR-TB treatment, particularly in patients with no overt signs of failure.…”